Individual
THERESA NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
450 BROOKLINE AVE, BOSTON, MA 02215
(617) 632-1906
Mailing address
450 BROOKLINE AVE, BOSTON, MA 02215
(617) 632-1906
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN2286457
MA
363LG0600X
Gerontology Nurse Practitioner
Primary
RN2286457
MA
Other
Enumeration date
07/19/2019
Last updated
12/03/2019
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